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Yang F, Xie B, Zhang H, Li T, Mao J, Chen Z, Peng Y, Li T, Sun S, Chen J, Chen Y, Du J. Return to flight duty (RTFD) after posterior lumbar spine surgery for symptomatic lumbar disc herniation (LDH) and lumbar isthmic spondylolisthesis (LIS) in Chinese military pilots. BMC Musculoskelet Disord 2024; 25:81. [PMID: 38245679 PMCID: PMC10799416 DOI: 10.1186/s12891-024-07175-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Symptomatic lumbar disc herniation (LDH) and lumbar isthmic spondylolisthesis (LIS) present significant challenges for military pilots, which may result in grounding if not effectively managed. Surgical treatment for LDH and LIS may offer a pathway to return to flight duty (RTFD), but recent data on this crucial topic is lacking. This study seeks to address this gap by investigating the RTFD outcomes among Chinese military pilots who have undergone lumbar spine surgery for symptomatic LDH and LIS. METHODS A retrospective review was conducted on active-duty military pilots who underwent isolated decompressive or fusion procedures at an authorized military medical center from March 1, 2007, to March 1, 2023. The analysis utilized descriptive statistics to examine demographic, occupational, surgical, and outcome data, with a particular focus on preoperative flight status, recommended clearance by spine surgeons, and actual RTFD outcomes and time. RESULTS Among the identified cases of active-duty military pilots with LDH or LIS treated by lumbar surgery (n = 24), 70.8% (17 of 24) consistently maintained RTFD status without encountering surgical complications or medical issues during the follow-up period. Of the seven pilots who did not RTFD, one retired within a year of surgery, two had anterior cruciate ligament injuries, three had residual radicular symptoms, and one had chronic low back pain. Excluding pilots who retired and did not RTFD for reasons unrelated to their lumbar conditions, the RTFD rate stood at 81.0% (17 of 21). The median time for recommended clearance by spine surgeons was 143.0 days (inter-quartile range, 116.5-196.0), while the median duration for actual RTFD attainment was 221.0 days (inter-quartile range, 182.0-300.0). The median follow-up post-lumbar surgery was 1.7 years (inter-quartile range, 0.4-2.9). CONCLUSION Most military pilots diagnosed with symptomatic LDH and LIS can continue their careers and regain active-duty flight status following lumbar spine surgery, as reflected by the high RTFD rate. Lumbar spine surgery can successfully alleviate the physical constraints associated with spinal conditions, facilitating the return of military pilots to their demanding profession.
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Affiliation(s)
- Fengyuan Yang
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China
- Graduate School of Medicine, China Medical University, Shenyang, 110122, China
| | - Bowen Xie
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China
- The Fifth School of Clinical Medicine, Air Force Clinical College, Anhui Medical University, Anhui, 230032, China
| | - Hongxing Zhang
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China
| | - Tianqi Li
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China
- Graduate School of Medicine, China Medical University, Shenyang, 110122, China
| | - Jian Mao
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China
- Graduate School of Medicine, China Medical University, Shenyang, 110122, China
| | - Zhiqiang Chen
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China
- Graduate School of Medicine, China Medical University, Shenyang, 110122, China
| | - Ye Peng
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China
| | - Tengfei Li
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China
| | - Siguo Sun
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China
| | - Jingyang Chen
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China
| | - Yufei Chen
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China.
| | - Junjie Du
- Department of Orthopedics, Air Force Medical Center of PLA, Beijing, 100142, China.
- Graduate School of Medicine, China Medical University, Shenyang, 110122, China.
- The Fifth School of Clinical Medicine, Air Force Clinical College, Anhui Medical University, Anhui, 230032, China.
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